Solutions for Successful Aging
What is Hospice?
Hospice is a free service to people with Medicare, Medicaid (or other primary insurance such as Blue Cross). If you have no insurance, Hospices will still provide services...basically, no one gets turned down for Hospice.
The goal of hospice is to keep people comfortable and keep them home surrounded by loved ones, instead of back and forth to the doctor's office and hospital. "Home" is defined as wherever the patient lives...be it nursing home, assisted living, a house, etc. In order to qualify for hospice you must have a terminal diagnosis of 6 months or less, no longer want to seek aggressive treatment or have an illness that has no treatment available. Of course only God knows how long any of us have and we have patients who live shorter or longer than 6 months. All you need to do is request hospice from the primary Doctor and he will take it from there. The patient must meet the qualifications specified under Medicare (or other insurance) guidelines. There are numerous diagnosis from dementia to cancer and each diagnosis comes with it's own set of guidelines.
Hospice provides an Interdisciplinary Team of people who will provide care and most importantly educate/teach you how to care for your loved one. They will also teach you what to expect as far as disease process and symptoms. The IDT team consists of the following:
1) A nurse available 24 hrs/7 days a week- The nurse will make weekly visits and the number of weekly visits will reflect what your loved one needs...most patients are seen 2-3 times a week. The nurse takes vital signs, manages medications, and manages symptoms and comfort. A nurse is available after hours and weekends on call for any needs. If your loved one were to develop a urinary tract infection or respiratory infection or anything else, the nurse would identify that and call in needed medications and allow the patient to stay at home. Plus a hospice nurse is an expert in symptom management that may not necessarily require medications...we have a lot of "tricks"
2) Hospice Aid- visits are also based on what you need- the Hospice Aid will bathe, provide personal care, change bed linens..whatever you need as well as bring supplies such as diapers, bed pads, creams, etc (all of which are provided free from Hospice)..they generally visit 2-3 times a week up to 5 times a week
3) Chaplain- non-demoninational and basically visits are to provide support and comfort- they base thier visits on what the patient/family wants- They generally visit 1-2 times/month
4) Social worker- the social worker is a good resource and is helpful with finding benefits you didn't know you had, sitters, community resources...etc They generally visit once a month, but will base thier visits on what you need as well
5) Medical Director- in addition to your attending Doctor, hospice has thier own Doctor who is available 24/7 for any prescription needs and is an expert in pain/symptom management. You also have a choice of just having the Hospice Medical Director be your primary doctor if you choose so
Hospice also pays for any medical equipment you need such as oxygen, hospital bed, walker, wheelchair, bedside commode...etc. They cover all the medications related to the primary diagnosis and medications used for comfort...for example if a patient is admitted under Dementia, hospice would cover dementia medications, anxiety meds, pain meds, nausea meds, constipation meds and so on. And like I mentioned, hospice will also pay for and provide supplies like diapers, bed pads, barrier creams and any wound care supplies needed.
If you choose to bring your loved one home live with you make sure you are up for the challenge. It will be like having a newborn again and he/she will require 24 hrs of your attention. Hospice will be a big help and teach you everything you need to know, but in the end Hospice is only supplemental help...they do not replace caregivers. On the other hand, if you are fully prepared and can commit the time, it can be a wonderful thing for your loved one.
If you choose to keep your loved one at the nursing home/assisted living, the hospice will coordinate thier careplan with the nursing home. The nursing home should not stop any of their services (ie...they should get the same nursing and nursing aid care as before...being on Hospice is EXTRA TLC) You have to be watchful b/c many nursing homes will stop having thier aids bathe because they have the hospice do all the work. The Hospice nurse as well as chaplain and SW will make thier visits to the nursing home as well. The hospice Medical Director can also recommend treatments/medications to the nursing home Doctor.
If you decide Hospice is right for you:
1. Request to interview more than one hospice (and request the nurse who would be her nurse to come to that interview).
2. Make a list of what you need/want and let them know your expectations.
3. Make sure the hospice Medical Director is either a Gerontologist or a Board Certified Hospice Medical Director.
4. Make sure the hospice bases all of their visits (nurse, aid...etc) on what you and your loved one need...You call the shots, not them
5. Also, many hospices will say if you take your loved one to the ER you have to revoke...this is not true..Medicare will pay for an ER visit if it is not related to the diagnosis..For example: if your loved one fell and broke something or had something come up that was not related to the primary diagnosis, he/she could remain on hospice and still go to the hospital
And finally, Hospice can be discontinued at any time (and can be resumed again at any time in the future) Also, if you are not happy with the Hospice you choose, you can change at any time. Hospice must continually evaluate a patients appropriateness (these are called benefit periods)...all that to say, nothing is permanent.
Hospice can be a wonderful thing and provide much needed support to patients and thier families. If you or your loved one would benefit from hospice services, talk to your doctor.
The goal of hospice is to keep people comfortable and keep them home surrounded by loved ones, instead of back and forth to the doctor's office and hospital. "Home" is defined as wherever the patient lives...be it nursing home, assisted living, a house, etc. In order to qualify for hospice you must have a terminal diagnosis of 6 months or less, no longer want to seek aggressive treatment or have an illness that has no treatment available. Of course only God knows how long any of us have and we have patients who live shorter or longer than 6 months. All you need to do is request hospice from the primary Doctor and he will take it from there. The patient must meet the qualifications specified under Medicare (or other insurance) guidelines. There are numerous diagnosis from dementia to cancer and each diagnosis comes with it's own set of guidelines.
Hospice provides an Interdisciplinary Team of people who will provide care and most importantly educate/teach you how to care for your loved one. They will also teach you what to expect as far as disease process and symptoms. The IDT team consists of the following:
1) A nurse available 24 hrs/7 days a week- The nurse will make weekly visits and the number of weekly visits will reflect what your loved one needs...most patients are seen 2-3 times a week. The nurse takes vital signs, manages medications, and manages symptoms and comfort. A nurse is available after hours and weekends on call for any needs. If your loved one were to develop a urinary tract infection or respiratory infection or anything else, the nurse would identify that and call in needed medications and allow the patient to stay at home. Plus a hospice nurse is an expert in symptom management that may not necessarily require medications...we have a lot of "tricks"
2) Hospice Aid- visits are also based on what you need- the Hospice Aid will bathe, provide personal care, change bed linens..whatever you need as well as bring supplies such as diapers, bed pads, creams, etc (all of which are provided free from Hospice)..they generally visit 2-3 times a week up to 5 times a week
3) Chaplain- non-demoninational and basically visits are to provide support and comfort- they base thier visits on what the patient/family wants- They generally visit 1-2 times/month
4) Social worker- the social worker is a good resource and is helpful with finding benefits you didn't know you had, sitters, community resources...etc They generally visit once a month, but will base thier visits on what you need as well
5) Medical Director- in addition to your attending Doctor, hospice has thier own Doctor who is available 24/7 for any prescription needs and is an expert in pain/symptom management. You also have a choice of just having the Hospice Medical Director be your primary doctor if you choose so
Hospice also pays for any medical equipment you need such as oxygen, hospital bed, walker, wheelchair, bedside commode...etc. They cover all the medications related to the primary diagnosis and medications used for comfort...for example if a patient is admitted under Dementia, hospice would cover dementia medications, anxiety meds, pain meds, nausea meds, constipation meds and so on. And like I mentioned, hospice will also pay for and provide supplies like diapers, bed pads, barrier creams and any wound care supplies needed.
If you choose to bring your loved one home live with you make sure you are up for the challenge. It will be like having a newborn again and he/she will require 24 hrs of your attention. Hospice will be a big help and teach you everything you need to know, but in the end Hospice is only supplemental help...they do not replace caregivers. On the other hand, if you are fully prepared and can commit the time, it can be a wonderful thing for your loved one.
If you choose to keep your loved one at the nursing home/assisted living, the hospice will coordinate thier careplan with the nursing home. The nursing home should not stop any of their services (ie...they should get the same nursing and nursing aid care as before...being on Hospice is EXTRA TLC) You have to be watchful b/c many nursing homes will stop having thier aids bathe because they have the hospice do all the work. The Hospice nurse as well as chaplain and SW will make thier visits to the nursing home as well. The hospice Medical Director can also recommend treatments/medications to the nursing home Doctor.
If you decide Hospice is right for you:
1. Request to interview more than one hospice (and request the nurse who would be her nurse to come to that interview).
2. Make a list of what you need/want and let them know your expectations.
3. Make sure the hospice Medical Director is either a Gerontologist or a Board Certified Hospice Medical Director.
4. Make sure the hospice bases all of their visits (nurse, aid...etc) on what you and your loved one need...You call the shots, not them
5. Also, many hospices will say if you take your loved one to the ER you have to revoke...this is not true..Medicare will pay for an ER visit if it is not related to the diagnosis..For example: if your loved one fell and broke something or had something come up that was not related to the primary diagnosis, he/she could remain on hospice and still go to the hospital
And finally, Hospice can be discontinued at any time (and can be resumed again at any time in the future) Also, if you are not happy with the Hospice you choose, you can change at any time. Hospice must continually evaluate a patients appropriateness (these are called benefit periods)...all that to say, nothing is permanent.
Hospice can be a wonderful thing and provide much needed support to patients and thier families. If you or your loved one would benefit from hospice services, talk to your doctor.
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© 2012 Created by Robyn Blaikie Collins.
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